Cargando…

2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida

BACKGROUND: Strongyloides stercoralis is a nematode endemic to the tropical and subtropical regions. In the United States, it is mostly found at southeastern states. Most infections are asymptomatic but disseminated and fatal infections have been reported in immunocompromised patients. At our instit...

Descripción completa

Detalles Bibliográficos
Autores principales: Perez-Lopez, Carlos J, Alrabaa, Sally, Aslam, Sadaf, Teo, Greg Matthew E, Kim, Teayoung, Reljic, Tea
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810699/
http://dx.doi.org/10.1093/ofid/ofz360.2369
_version_ 1783462311360462848
author Perez-Lopez, Carlos J
Alrabaa, Sally
Aslam, Sadaf
Teo, Greg Matthew E
Kim, Teayoung
Reljic, Tea
author_facet Perez-Lopez, Carlos J
Alrabaa, Sally
Aslam, Sadaf
Teo, Greg Matthew E
Kim, Teayoung
Reljic, Tea
author_sort Perez-Lopez, Carlos J
collection PubMed
description BACKGROUND: Strongyloides stercoralis is a nematode endemic to the tropical and subtropical regions. In the United States, it is mostly found at southeastern states. Most infections are asymptomatic but disseminated and fatal infections have been reported in immunocompromised patients. At our institution, universal screening through Strongyloides antibody detection in serum among solid-organ transplant candidates began since 2010 and all seropositive candidates are treated before transplantation. We previously determined our incidence to be about 5%. The aim of this study was to determine demographic characteristics and risk factors that can be used for more cost-effective targeted screening. METHODS: We performed a retrospective cohort study of patients who underwent transplant evaluation from 2014 to 2016. A total of 228 charts were reviewed for Strongyloides serology status, eosinophilia, demographics and risk factors. Chi-square and Fisher exact tests were used to do a comparative analysis between Strongyloides seropositive and seronegative cohorts. RESULTS: We identified 113 seropositive (SP) patients and 115 seronegative (SN) patients. There were more males in the seropositive group (79%) compared with seronegative group (62%) (P = 0.005). Caucasians predominated in both groups (SP 71% vs. SN 57%; P = 0.286). No significant difference was found between both groups with regards to occupation with soil or water contact (SP 38% vs. SN 30%; P = 0.281), birthplace outside USA or travel outside of United States (SP 31% vs. SN 36%; P = 0.732). Eosinophilia occurred less in the seropositive group compared with the seronegative group (SP 16% vs. SN 30%; P = 0.030). CONCLUSION: The study did not find any statistically significant difference in the demographic characteristics or risk factors that can be used for prediction of Strongyloides seropositivity among solid-organ transplant candidates. Hence, our institution will continue universal screening for Strongyloides stercoralis for all our transplant candidates. Our findings further question donor screening for Strongyloides that uses a similar questionnaire which may not be reliable to identify those infected with this parasite. This would put recipients at risk for a donor-transmitted infection. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures.
format Online
Article
Text
id pubmed-6810699
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-68106992019-10-28 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida Perez-Lopez, Carlos J Alrabaa, Sally Aslam, Sadaf Teo, Greg Matthew E Kim, Teayoung Reljic, Tea Open Forum Infect Dis Abstracts BACKGROUND: Strongyloides stercoralis is a nematode endemic to the tropical and subtropical regions. In the United States, it is mostly found at southeastern states. Most infections are asymptomatic but disseminated and fatal infections have been reported in immunocompromised patients. At our institution, universal screening through Strongyloides antibody detection in serum among solid-organ transplant candidates began since 2010 and all seropositive candidates are treated before transplantation. We previously determined our incidence to be about 5%. The aim of this study was to determine demographic characteristics and risk factors that can be used for more cost-effective targeted screening. METHODS: We performed a retrospective cohort study of patients who underwent transplant evaluation from 2014 to 2016. A total of 228 charts were reviewed for Strongyloides serology status, eosinophilia, demographics and risk factors. Chi-square and Fisher exact tests were used to do a comparative analysis between Strongyloides seropositive and seronegative cohorts. RESULTS: We identified 113 seropositive (SP) patients and 115 seronegative (SN) patients. There were more males in the seropositive group (79%) compared with seronegative group (62%) (P = 0.005). Caucasians predominated in both groups (SP 71% vs. SN 57%; P = 0.286). No significant difference was found between both groups with regards to occupation with soil or water contact (SP 38% vs. SN 30%; P = 0.281), birthplace outside USA or travel outside of United States (SP 31% vs. SN 36%; P = 0.732). Eosinophilia occurred less in the seropositive group compared with the seronegative group (SP 16% vs. SN 30%; P = 0.030). CONCLUSION: The study did not find any statistically significant difference in the demographic characteristics or risk factors that can be used for prediction of Strongyloides seropositivity among solid-organ transplant candidates. Hence, our institution will continue universal screening for Strongyloides stercoralis for all our transplant candidates. Our findings further question donor screening for Strongyloides that uses a similar questionnaire which may not be reliable to identify those infected with this parasite. This would put recipients at risk for a donor-transmitted infection. [Image: see text] [Image: see text] DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2019-10-23 /pmc/articles/PMC6810699/ http://dx.doi.org/10.1093/ofid/ofz360.2369 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Perez-Lopez, Carlos J
Alrabaa, Sally
Aslam, Sadaf
Teo, Greg Matthew E
Kim, Teayoung
Reljic, Tea
2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title_full 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title_fullStr 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title_full_unstemmed 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title_short 2692. Comparison of Demographics and Risk factors Between Strongyloides stercoralis Seropositive and Seronegative Solid-Organ Transplant Candidates: Experience from a Tertiary Acute Care Center in Florida
title_sort 2692. comparison of demographics and risk factors between strongyloides stercoralis seropositive and seronegative solid-organ transplant candidates: experience from a tertiary acute care center in florida
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6810699/
http://dx.doi.org/10.1093/ofid/ofz360.2369
work_keys_str_mv AT perezlopezcarlosj 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida
AT alrabaasally 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida
AT aslamsadaf 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida
AT teogregmatthewe 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida
AT kimteayoung 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida
AT reljictea 2692comparisonofdemographicsandriskfactorsbetweenstrongyloidesstercoralisseropositiveandseronegativesolidorgantransplantcandidatesexperiencefromatertiaryacutecarecenterinflorida